www.mida.gov.my ML (08) (03.01.2013) APPLICATION FOR MANUFACTURING LICENCE New Regularisation Expansion Diversification (Company Previously Exempted From Manufacturing License) Section A: Company Profile Income Tax Ref. No. (if applicable) ROC No. Manufacturing Licence No. (if applicable) Company Name Mailing Address Tel. No. Fax No. Website Email HS Tariff Code Products / Activities Annual Production Capacity Factory Location / Tel No. / E-mail New / Existing Additional (if applicable) Please attach manufacturing process flow chart, list of major machinery and raw materials and copies of Manufacturing Licences and conditions granted to the company (if any) Source of Technology A. For existing company with approved Manufacturing Licence applying for Expansion/ Diversification project, please provide additional values/figures only for Sections B, C, D, E & F. For companies previously exempted from Manufacturing Licence, please provide total value for all Sections B, C, D, E & F. B. Section B: Project Cost 1. Cost of Fixed Assets : Item Value a) Land (RM) b) Factory (RM) c) Plant/Machinery (RM) d) Other Equipment (RM) Total (RM) 2. Pre-operational Expenditure (RM) 3. Working Capital (RM) (Current Assets - Current Liabilities) 4. Total Project Cost (1+2+3) (RM) Annual Lease (if applicable) ML (08) Section C: Financing 5. Capital Structure : (RM) 1. Authorised Capital 2. Shareholders’ Fund (a) Paid Up Capital (i) Malaysian Individuals Bumiputera Non-Bumiputera (ii) Company Incorporated in Malaysia* (iii) Foreign Nationals / Companies (specify Name and Nationality / Country of Origin) Total of (i), (ii) and (iii) (b) Reserves (excluding capital appreciation) Total of (a) and (b) *For 2(a)(ii), please provide equity structure as follows: Name Bumiputera (%) RM Non Bumiputera (%) Foreign (specify country) (%) i) ii) 6. Loan (RM) a) Domestic b) Foreign (specify country of origin) Total of (a) and (b) 7. Other Sources (please specify) (RM) a) b) Total of (a) and (b) Section D: Employment Section E: Sales 8. Please provide information as per APPENDIX I. Section E: Sales 10. Proposed Export (%): 11. Product Pricing Details : Item % of ex-factory price for each product Product 1 a) Cost of Raw Materials / Components b) Cost of Labour c) Other Costs d) Manufacturing Profit 2 Product 2 Product 3 ML (08) Total 100% 100% 100% Section F: Estimated Labour Cost and Earnings Section E: Sales 12. Please provide information as per APPENDIX II. Section G: Declaration I, , the Managing Director of (i) hereby declare that the particulars furnished in this application are true. (ii)* have engaged/is planning to engage the services of the following consultant for my application : Company Name : Address : Contact Person : Designation : Telephone no. : Fax no. : E-mail : I take full responsibility for all information submitted by the consultant(s). Date (Signature) (Company’s Stamp or Seal) *Please complete this section if the company has engaged/is planning to engage the services of consultant(s) to act on behalf of the company. Please provide information on a separate sheet of paper if space is insufficient 3 ML (08) APPENDIX I Section D: Employment Please note that the information is required to enable the government to undertake the appropriate manpower planning to meet the specific manpower needs of companies proposing to establish projects in Malaysia. Number of Persons Employed by Average Monthly Salary* (RM) 5,00010,000 and <3,000 3,000-<5,000 <10,000 above Malaysian 1. Managerial and Professional 2. Technical and supervisory staff with (a) Engineering/Technical qualifications (b) Science qualifications (c) Other qualifications / experience Foreign National Malaysian Foreign National Malaysian Foreign National Malaysian Foreign National Craft skills such as plant maintenance mechanic, tool & die maker, machinist, IT personnel (including CAD/CAM designer & DCS operator), Quality Controller, Electrician, Chargeman, Welder) 3. (a) Sales and clerical (b) Other general workers 4. Machine operators and assemblers** Total Note: * include wages, salaries, bonuses, social insurance contribution and all employee benefits. If there is more than one factory location, please provide the same information on a separate sheet of paper. ** Machine operators and assemblers are those involved in the production/assembly line who receive mainly on-the-job training for a period between 3 to 6 months,e.g. production operators. 1. Percentage of science and technical staff having degrees or diplomas with a minimum of 5 years experience (of the total workforce) 2. Number of Staff with Post Graduate (ie. Masters/PhD etc) qualifications 3. In addition to the full-time employees as mentioned in the above tables, please provide the 4 number of workers which are outsourced (not under the company’s payroll) : ______ % : ______ : ______ ML (08) APPENDIX II Section F: Estimated Labour Cost and Earnings A. ESTIMATED LABOUR COST - Salaries and Wages* Year in Operation Year 1 Year 2 Year 3 Salaries and Wages (RM) Note: *Include wages, salaries, bonuses, social insurance contribution and all employee benefits B. ESTIMATED EARNINGS Year in Operation Year 1 (a) Estimated Earnings before Interest, Tax, Depreciation & Amortization (EBITDA) (RM) (b) Estimated Net Income After Tax (RM) - Held in Malaysia as reserves (%) - Remitted out of Malaysia (%) - Reinvested in Malaysia (%) 5 Year 2 Year 3